Contemporary clinical profile and outcome of prosthetic valve endocarditis
Identifieur interne : 002388 ( PascalFrancis/Curation ); précédent : 002387; suivant : 002389Contemporary clinical profile and outcome of prosthetic valve endocarditis
Auteurs : Andrew Wang [États-Unis] ; Eugene Athan [Australie] ; Paul A. Pappas [États-Unis] ; Vance G. Jr Fowler [États-Unis] ; Lars Olaison [Suède] ; Carlos Pare [Espagne] ; Benito Almirante [Espagne] ; Patricia Munoz [Espagne] ; Marco Rizzi [Italie] ; Christoph Naber [Allemagne] ; Mateja Logar [Slovénie] ; Pierre Tattevin [France] ; Diana L. Iarussi [Italie] ; Christine Selton-Suty [France] ; Sandra Braun Jones [Chili] ; José Casabe [Argentine] ; Arthur Morris [Nouvelle-Zélande] ; Ralph Corey [États-Unis] ; Christopher H. Cabell [États-Unis]Source :
- JAMA, the journal of the American Medical Association [ 0098-7484 ] ; 2007.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Médecine.
English descriptors
- KwdEn :
Abstract
Context Prosthetic valve endocarditis (PVE) is associated with significant mortality and morbidity. The contemporary clinical profile and outcome of PVE are not well defined. Objectives To describe the prevalence, clinical characteristics, and outcome of PVE, with attention to health care-associated infection, and to determine prognostic factors associated with in-hospital mortality. Design, Setting, and Participants Prospective, observational cohort study conducted at 61 medical centers in 28 countries, including 556 patients with definite PVE as defined by Duke University diagnostic criteria who were enrolled in the International Collaboration on Endocarditis-Prospective Cohort Study from June 2000 to August 2005. Main Outcome Measure In-hospital mortality. Results Definite PVE was present in 556 (20.1 %) of 2670 patients with infective endocarditis. Staphylococcus aureus was the most common causative organism (128 patients [23.0%]), followed by coagulase-negative staphylococci (94 patients [16.9%]). Health care-associated PVE was present in 203 (36.5%) of the overall cohort. Seventy-one percent of health care-associated PVE occurred within the first year of valve implantation, and the majority of cases were diagnosed after the early (60-day) period. Surgery was performed in 272 (48.9%) patients during the index hospitalization. In-hospital death occurred in 127 (22.8%) patients and was predicted by older age, health care-associated infection (62/203 [30.5%]; adjusted odds ratio [OR], 1.62; 95% confidence interval [Cl], 1.08-2.44; P=.02), S aureus infection (44/128 [34.4%]; adjusted OR, 1.73; 95% Cl, 1.01-2.95; P=.05), and complications of PVE, including heart failure (60/183 [32.8%]; adjusted OR, 2.33; 95% Cl, 1.62-3.34; P<.001), stroke (34/101 [33.7%]; adjusted OR, 2.25; 95% Cl, 1.25-4.03; P=.007), intracardiac abscess (47/144 [32.6%]; adjusted OR, 1.86; 95% Cl, 1.10-3.15; P=.02), and persistent bacteremia (27/49 [55.1 %]; adjusted OR, 4.29; 95% Cl, 1.99-9.22; P<.001). Conclusions Prosthetic valve endocarditis accounts for a high percentage of all cases of infective endocarditis in many regions of the world. Staphylococcus aureus is now the leading cause of PVE. Health care-associated infection significantly influences the clinical characteristics and outcome of PVE. Complications of PVE strongly predict in-hospital mortality, which remains high despite prompt diagnosis and the frequent use of surgical intervention.
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Contemporary clinical profile and outcome of prosthetic valve endocarditis</title>
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<author><name sortKey="Munoz, Patricia" sort="Munoz, Patricia" uniqKey="Munoz P" first="Patricia" last="Munoz">Patricia Munoz</name>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Endocarditis</term>
<term>Evolution</term>
<term>Heart valve</term>
<term>Medicine</term>
<term>Prognosis</term>
<term>Prosthesis</term>
<term>Symptomatology</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Prothèse</term>
<term>Symptomatologie</term>
<term>Evolution</term>
<term>Endocardite</term>
<term>Pronostic</term>
<term>Valvule cardiaque</term>
<term>Médecine</term>
</keywords>
<keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Médecine</term>
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<front><div type="abstract" xml:lang="en">Context Prosthetic valve endocarditis (PVE) is associated with significant mortality and morbidity. The contemporary clinical profile and outcome of PVE are not well defined. Objectives To describe the prevalence, clinical characteristics, and outcome of PVE, with attention to health care-associated infection, and to determine prognostic factors associated with in-hospital mortality. Design, Setting, and Participants Prospective, observational cohort study conducted at 61 medical centers in 28 countries, including 556 patients with definite PVE as defined by Duke University diagnostic criteria who were enrolled in the International Collaboration on Endocarditis-Prospective Cohort Study from June 2000 to August 2005. Main Outcome Measure In-hospital mortality. Results Definite PVE was present in 556 (20.1 %) of 2670 patients with infective endocarditis. Staphylococcus aureus was the most common causative organism (128 patients [23.0%]), followed by coagulase-negative staphylococci (94 patients [16.9%]). Health care-associated PVE was present in 203 (36.5%) of the overall cohort. Seventy-one percent of health care-associated PVE occurred within the first year of valve implantation, and the majority of cases were diagnosed after the early (60-day) period. Surgery was performed in 272 (48.9%) patients during the index hospitalization. In-hospital death occurred in 127 (22.8%) patients and was predicted by older age, health care-associated infection (62/203 [30.5%]; adjusted odds ratio [OR], 1.62; 95% confidence interval [Cl], 1.08-2.44; P=.02), S aureus infection (44/128 [34.4%]; adjusted OR, 1.73; 95% Cl, 1.01-2.95; P=.05), and complications of PVE, including heart failure (60/183 [32.8%]; adjusted OR, 2.33; 95% Cl, 1.62-3.34; P<.001), stroke (34/101 [33.7%]; adjusted OR, 2.25; 95% Cl, 1.25-4.03; P=.007), intracardiac abscess (47/144 [32.6%]; adjusted OR, 1.86; 95% Cl, 1.10-3.15; P=.02), and persistent bacteremia (27/49 [55.1 %]; adjusted OR, 4.29; 95% Cl, 1.99-9.22; P<.001). Conclusions Prosthetic valve endocarditis accounts for a high percentage of all cases of infective endocarditis in many regions of the world. Staphylococcus aureus is now the leading cause of PVE. Health care-associated infection significantly influences the clinical characteristics and outcome of PVE. Complications of PVE strongly predict in-hospital mortality, which remains high despite prompt diagnosis and the frequent use of surgical intervention.</div>
</front>
</TEI>
<inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0098-7484</s0>
</fA01>
<fA03 i2="1"><s0>JAMA j. Am. Med. Assoc.</s0>
</fA03>
<fA05><s2>297</s2>
</fA05>
<fA06><s2>12</s2>
</fA06>
<fA08 i1="01" i2="1" l="ENG"><s1>Contemporary clinical profile and outcome of prosthetic valve endocarditis</s1>
</fA08>
<fA11 i1="01" i2="1"><s1>WANG (Andrew)</s1>
</fA11>
<fA11 i1="02" i2="1"><s1>ATHAN (Eugene)</s1>
</fA11>
<fA11 i1="03" i2="1"><s1>PAPPAS (Paul A.)</s1>
</fA11>
<fA11 i1="04" i2="1"><s1>FOWLER (Vance G. JR)</s1>
</fA11>
<fA11 i1="05" i2="1"><s1>OLAISON (Lars)</s1>
</fA11>
<fA11 i1="06" i2="1"><s1>PARE (Carlos)</s1>
</fA11>
<fA11 i1="07" i2="1"><s1>ALMIRANTE (Benito)</s1>
</fA11>
<fA11 i1="08" i2="1"><s1>MUNOZ (Patricia)</s1>
</fA11>
<fA11 i1="09" i2="1"><s1>RIZZI (Marco)</s1>
</fA11>
<fA11 i1="10" i2="1"><s1>NABER (Christoph)</s1>
</fA11>
<fA11 i1="11" i2="1"><s1>LOGAR (Mateja)</s1>
</fA11>
<fA11 i1="12" i2="1"><s1>TATTEVIN (Pierre)</s1>
</fA11>
<fA11 i1="13" i2="1"><s1>IARUSSI (Diana L.)</s1>
</fA11>
<fA11 i1="14" i2="1"><s1>SELTON-SUTY (Christine)</s1>
</fA11>
<fA11 i1="15" i2="1"><s1>BRAUN JONES (Sandra)</s1>
</fA11>
<fA11 i1="16" i2="1"><s1>CASABE (José)</s1>
</fA11>
<fA11 i1="17" i2="1"><s1>MORRIS (Arthur)</s1>
</fA11>
<fA11 i1="18" i2="1"><s1>COREY (Ralph)</s1>
</fA11>
<fA11 i1="19" i2="1"><s1>CABELL (Christopher H.)</s1>
</fA11>
<fA14 i1="01"><s1>Department of Medicine, Duke University Medical Center</s1>
<s2>Durham, NC</s2>
<s3>USA</s3>
<sZ>1 aut.</sZ>
<sZ>4 aut.</sZ>
<sZ>18 aut.</sZ>
<sZ>19 aut.</sZ>
</fA14>
<fA14 i1="02"><s1>Department of Infectious Disease, The Geelong Hospital at the University of Melbourne</s1>
<s2>Melbourne</s2>
<s3>AUS</s3>
<sZ>2 aut.</sZ>
</fA14>
<fA14 i1="03"><s1>Outcomes Research and Assessment Group, Duke Clinical Research Institute</s1>
<s2>Durham, NC</s2>
<s3>USA</s3>
<sZ>3 aut.</sZ>
</fA14>
<fA14 i1="04"><s1>Department of Infectious Disease, Sahlgrenska Universitetssjukhuset/ Ostra</s1>
<s2>Göteborg</s2>
<s3>SWE</s3>
<sZ>5 aut.</sZ>
</fA14>
<fA14 i1="05"><s1>Department of Cardiology, University of Barcelona</s1>
<s2>Barcelona</s2>
<s3>ESP</s3>
<sZ>6 aut.</sZ>
</fA14>
<fA14 i1="06"><s1>Infectious Diseases Department, Hospital Universitari Vall d'Hebron</s1>
<s2>Barcelona</s2>
<s3>ESP</s3>
<sZ>7 aut.</sZ>
</fA14>
<fA14 i1="07"><s1>Department of Infectious Disease, Hospital General Universitario Gregorio Maranon</s1>
<s2>Barcelona</s2>
<s3>ESP</s3>
<sZ>8 aut.</sZ>
</fA14>
<fA14 i1="08"><s1>Department of Infectious Disease, Ospedali Riuniti</s1>
<s2>Bergamo</s2>
<s3>ITA</s3>
<sZ>9 aut.</sZ>
</fA14>
<fA14 i1="09"><s1>Cardiology Clinic, University Essen</s1>
<s2>Essen</s2>
<s3>DEU</s3>
<sZ>10 aut.</sZ>
</fA14>
<fA14 i1="10"><s1>Department of Infectious Disease, Medical Center Ljublijana</s1>
<s2>Ljublijana</s2>
<s3>SVN</s3>
<sZ>11 aut.</sZ>
</fA14>
<fA14 i1="11"><s1>Department of Infec tious Disease, Pontchaillou University</s1>
<s2>Rennes</s2>
<s3>FRA</s3>
<sZ>12 aut.</sZ>
</fA14>
<fA14 i1="12"><s1>Department of Cardiology, II Universita di Napoli</s1>
<s2>Naples</s2>
<s3>ITA</s3>
<sZ>13 aut.</sZ>
</fA14>
<fA14 i1="13"><s1>Cardiology Service, CHU Nancy-Brabois</s1>
<s2>Nancy</s2>
<s3>FRA</s3>
<sZ>14 aut.</sZ>
</fA14>
<fA14 i1="14"><s1>Laboratorio de Tecnicas No Invasivas, Hospital Clinico Pont Universidad Catolica de Chile</s1>
<s2>Santiago</s2>
<s3>CHL</s3>
<sZ>15 aut.</sZ>
</fA14>
<fA14 i1="15"><s1>Department of Cardiology, Institute de Cardiologia y Cirugia Cardiovascular, Fundacion Favaloro</s1>
<s2>Buenos Aires</s2>
<s3>ARG</s3>
<sZ>16 aut.</sZ>
</fA14>
<fA14 i1="16"><s1>Diagnostic Medlab, Auckland City Hospital</s1>
<s2>Auckland</s2>
<s3>NZL</s3>
<sZ>17 aut.</sZ>
</fA14>
<fA20><s1>1354-1361</s1>
</fA20>
<fA21><s1>2007</s1>
</fA21>
<fA23 i1="01"><s0>ENG</s0>
</fA23>
<fA43 i1="01"><s1>INIST</s1>
<s2>5051</s2>
<s5>354000145706680070</s5>
</fA43>
<fA44><s0>0000</s0>
<s1>© 2007 INIST-CNRS. All rights reserved.</s1>
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<fA45><s0>41 ref.</s0>
</fA45>
<fA47 i1="01" i2="1"><s0>07-0191068</s0>
</fA47>
<fA60><s1>P</s1>
</fA60>
<fA61><s0>A</s0>
</fA61>
<fA64 i1="01" i2="1"><s0>JAMA, the journal of the American Medical Association</s0>
</fA64>
<fA66 i1="01"><s0>USA</s0>
</fA66>
<fC01 i1="01" l="ENG"><s0>Context Prosthetic valve endocarditis (PVE) is associated with significant mortality and morbidity. The contemporary clinical profile and outcome of PVE are not well defined. Objectives To describe the prevalence, clinical characteristics, and outcome of PVE, with attention to health care-associated infection, and to determine prognostic factors associated with in-hospital mortality. Design, Setting, and Participants Prospective, observational cohort study conducted at 61 medical centers in 28 countries, including 556 patients with definite PVE as defined by Duke University diagnostic criteria who were enrolled in the International Collaboration on Endocarditis-Prospective Cohort Study from June 2000 to August 2005. Main Outcome Measure In-hospital mortality. Results Definite PVE was present in 556 (20.1 %) of 2670 patients with infective endocarditis. Staphylococcus aureus was the most common causative organism (128 patients [23.0%]), followed by coagulase-negative staphylococci (94 patients [16.9%]). Health care-associated PVE was present in 203 (36.5%) of the overall cohort. Seventy-one percent of health care-associated PVE occurred within the first year of valve implantation, and the majority of cases were diagnosed after the early (60-day) period. Surgery was performed in 272 (48.9%) patients during the index hospitalization. In-hospital death occurred in 127 (22.8%) patients and was predicted by older age, health care-associated infection (62/203 [30.5%]; adjusted odds ratio [OR], 1.62; 95% confidence interval [Cl], 1.08-2.44; P=.02), S aureus infection (44/128 [34.4%]; adjusted OR, 1.73; 95% Cl, 1.01-2.95; P=.05), and complications of PVE, including heart failure (60/183 [32.8%]; adjusted OR, 2.33; 95% Cl, 1.62-3.34; P<.001), stroke (34/101 [33.7%]; adjusted OR, 2.25; 95% Cl, 1.25-4.03; P=.007), intracardiac abscess (47/144 [32.6%]; adjusted OR, 1.86; 95% Cl, 1.10-3.15; P=.02), and persistent bacteremia (27/49 [55.1 %]; adjusted OR, 4.29; 95% Cl, 1.99-9.22; P<.001). Conclusions Prosthetic valve endocarditis accounts for a high percentage of all cases of infective endocarditis in many regions of the world. Staphylococcus aureus is now the leading cause of PVE. Health care-associated infection significantly influences the clinical characteristics and outcome of PVE. Complications of PVE strongly predict in-hospital mortality, which remains high despite prompt diagnosis and the frequent use of surgical intervention.</s0>
</fC01>
<fC02 i1="01" i2="X"><s0>002B01</s0>
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<fC02 i1="02" i2="X"><s0>002B25I</s0>
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<fC02 i1="03" i2="X"><s0>002B12A04</s0>
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<fC03 i1="01" i2="X" l="FRE"><s0>Prothèse</s0>
<s5>01</s5>
</fC03>
<fC03 i1="01" i2="X" l="ENG"><s0>Prosthesis</s0>
<s5>01</s5>
</fC03>
<fC03 i1="01" i2="X" l="SPA"><s0>Prótesis</s0>
<s5>01</s5>
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<fC03 i1="02" i2="X" l="FRE"><s0>Symptomatologie</s0>
<s5>02</s5>
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</fC03>
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<s5>03</s5>
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<fC03 i1="04" i2="X" l="FRE"><s0>Endocardite</s0>
<s5>04</s5>
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<fC03 i1="04" i2="X" l="ENG"><s0>Endocarditis</s0>
<s5>04</s5>
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<s5>04</s5>
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<s5>05</s5>
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<s5>05</s5>
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<fC03 i1="05" i2="X" l="SPA"><s0>Pronóstico</s0>
<s5>05</s5>
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<s5>06</s5>
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<s5>37</s5>
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<fC07 i1="01" i2="X" l="SPA"><s0>Aparato circulatorio patología</s0>
<s5>37</s5>
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<fC07 i1="02" i2="X" l="FRE"><s0>Cardiopathie</s0>
<s5>38</s5>
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<fC07 i1="02" i2="X" l="ENG"><s0>Heart disease</s0>
<s5>38</s5>
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<fC07 i1="02" i2="X" l="SPA"><s0>Cardiopatía</s0>
<s5>38</s5>
</fC07>
<fC07 i1="03" i2="X" l="FRE"><s0>Endocarde pathologie</s0>
<s5>39</s5>
</fC07>
<fC07 i1="03" i2="X" l="ENG"><s0>Endocardial disease</s0>
<s5>39</s5>
</fC07>
<fC07 i1="03" i2="X" l="SPA"><s0>Endocardio patología</s0>
<s5>39</s5>
</fC07>
<fN21><s1>128</s1>
</fN21>
<fN44 i1="01"><s1>OTO</s1>
</fN44>
<fN82><s1>OTO</s1>
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